One-lung Ventilation for Patients With Laryngo-tracheal Stenosis: A Case Report and Literature Review.

Context: Laryngo-tracheal stenosis (LTS) is a relatively rare disease, and conventional methods have difficulty achieving one-lung ventilation (OLV) when an anatomical abnormality exists. Selecting an appropriate method for patients with LTS can ensure oxygenation, collapse the lung, and reduce damage. Objective: The study intended to perform a comprehensive review of the literature and a systematic review to examine the characteristics and management of OLV for LTS patients. Design: The research team performed a narrative review by searching the PubMed and China National Knowledge Infrastructure (CNKI) databases. The search used the keywords one-lung ventilation and tracheal stenosis. The team then performed a review, including the studies found in the search and the research team's own case study. Setting: The study took place at the First Hospital of Jilin University in Changchun, Jilin, China. Participant: The participant in the current case study was a 72-year-old, female patient with generalized tracheal narrowing. Results: Nine participants achieved OLV through BB, with the anesthesiologist performing SLT and using extraluminal BB for six participants. Conclusions: Several methods can successfully achieve OLV for patients with difficult airways, but the current research team found that a small, single-lumen tube (SLT) and extraluminal bronchial blocker (BB) may be a better choice for patients with tracheal stenosis.

An initial experience with an Extraluminal EZ-Blocker® : A new alternative for 1-lung ventilation in pediatric patients.

BACKGROUND: The need for 1-lung ventilation in school age, pediatric patients is uncommon and as a result there are relatively few devices available to facilitate lung isolation in this population. Furthermore, little is known about the efficacy and techniques of placement of the currently available devices. One of the newest devices available that may be appropriate in this age group is the EZ-Blocker. AIMS: We aimed to examine our initial experience with the EZ-Blocker to evaluate the performance of this device with respect to potential improvements in technique and patient selection going forward. METHODS: We performed a retrospective chart review of all pediatric patients who underwent 1-lung ventilation with an EZ-Blocker since the blocker became available at our institution. We recorded demographics, details of placement, intraoperative course, number of repositions, and any postoperative morbidity related to blocker placement or 1-lung ventilation. RESULTS: We were able to correctly place the EZ-Blocker and achieve lung isolation in 8 of 11 patients. There was a single episode of repositioning required during 1-lung ventilation with an EZ-Blocker. CONCLUSION: The EZ-Blocker was successful in providing lung isolation for a majority of our school age patients. Size constraints in children <6 years of age, excessive secretions, and distortions of tracheal anatomy seemed to be the greatest hindrances to successful placement and positioning of the device. Once correctly positioned, however, the EZ-Blocker may be more stable than the Arndt endobronchial blocker.